Healthcare Provider Details

I. General information

NPI: 1194179333
Provider Name (Legal Business Name): DHRUV VASANT M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

1725 SPRING HILL AVE
MOBILE AL
36604-1402
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-7289
  • Fax: 251-435-1616
Mailing address:
  • Phone: 251-435-7289
  • Fax: 251-435-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA10813200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD90245
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD16585
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10813200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: